Organization
COASTAL HEALTH PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI D CLARK (BILLING SUPERVISOR)
(831) 763-6487
Entity
Organization
Contact information
Practice address
65 NEILSON ST, SUITE 102, WATSONVILLE, CA 95076-2491
(831) 768-6217
(831) 768-6219
Mailing address
65 NEILSON ST STE 102, WATSONVILLE, CA 95076-2491
(831) 768-6217
(831) 768-6219
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RN0300X
Nephrology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437599032
—
CA
Enumeration date
06/27/2013
Last updated
02/23/2021
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